Grabbing a monster by the tail

The monster is HIV/AIDS. The thoughtless action has been to wage ceaseless propaganda that everyone should be tested, even as a positive test is said to mean stigma, lifelong disability, and an early death. Some consequences are coming home to roost in South Africa:

“The national health department and the Treatment Action Campaign (TAC) have added their voices to condemning the use of HIV home testing kits, saying they are risky to use at home and their accuracy cannot be guaranteed. This follows a warning from the SA Medical Association (Sama), which cautioned that home testing for HIV could leave people devastated. . . . TAC general secretary Vuyiseka Dubula warned against the use of the kits. Suicides could result if people tested at home and got a positive result. . . . ‘When doing an HIV test it’s very important to know why you are doing it, and to have a proper support system’” (“South Africa: HIV Home Tests – More Warnings”).Doesn’t it seem rather odd, that someone who keeps urging everyone to get tested then implies or insists that they need some other reason for being tested than that everyone is being urged to get tested?
Perhaps there’s a subliminal awareness that the tests are often misleading?

“Dubula also questioned the accuracy of home testing kits, saying there was no confirmation. ‘All HIV tests must be confirmed. The worry with self-testing is that it’s not always possible to confirm the results. Some people may not be able to afford to buy a second kit to confirm their results,’ she said, urging people to get free tests at public health facilities.”But there’s no such thing as a confirming HIV test, according to “Laboratory detection of human retroviral infection” by Stanley H. Weiss and Elliott P. Cowan, Chapter 8 in AIDS and Other Manifestations of HIV Infection, ed. Gary P. Wormser, 4th ed. (2004). None of the tests are capable of establishing the presence of HIV infection; all results should be expressed as probabilities; so-called “confirmatory” tests are actually only supplemental tests, to be used only as additional adjuncts to clinical observation and medical histories. “Each individual assay has its own associated special characteristics and is not interchangeable with other assays, even within a given class of test” (p. 148). “In the absence of gold standards, the true sensitivity and specificity for the detection of HIV antibodies remain somewhat imprecise” (p. 150).
The truly monstrous fact is that the public hears constantly about confirmatory tests and the 99%+ sensitivity and specificity of HIV testing at the same time as the expert technical literature emphasizes that such a high “accuracy” still means that in low-risk groups the probability of false positives may be 5 out of 6 and that no test or sequence of tests can prove infection (“’HIV’ tests are self-fulfilling prophecies”, 10 May 2009).

When public policies are based on ignorance, this is the sort of mess that ensues. On the one hand, the policy makers are told that “rapid testing may assist in facilitating the diagnosis of HIV infection, improving HIV testing capabilities in facilities without access to laboratories”; on the other hand it’s recognized that “There was also the danger of misinterpretation of the results of the home test kit . . . . Professor Peter Eagles, chairman of the Medical Control Council . . . said consumers needed to ensure the product was of a good quality, and registered in its country of origin.”
How, one might logically ask, should the typical “consumer” in Africa distinguish advertisements by makers of the home-test kits from other propaganda they are subjected to? But perhaps above all, consider the implications of the assertion that “rapid testing”, notoriously unreliable in itself, can assist with “diagnosis of HIV infection”, when Weiss & Cowan go to great pains to describe the lengthy, elaborate procedures required to diagnose infection in ways that do not rely exclusively on test results.

There is a similar disconnect between the incessant propaganda to distribute antiretroviral drugs in Africa and the considered views of the treatment experts that antiretroviral treatment requires constant careful monitoring, frequent laboratory testing, the likelihood of needing to change treatments at intervals, the elaborate procedures like “resistance testing” to choose the right treatment regimens in the first place:
” Multiple studies have demonstrated that better outcomes are achieved in HIV-infected outpatients cared for by a clinician with HIV expertise [1-6], which reflects the complexity of HIV infection and its treatment. Thus, appropriate training and experience, as well as ongoing continuing medical education (CME), are important components for optimal care. Primary care providers without HIV experience, such as those who provide service in rural or underserved areas, should identify experts in the region who will provide consultation when needed” (NIH Treatment Guidelines, 1 December 2009, p. 3).

It seems more than likely that good nutrition and vitamins and mineral supplements would do far more good in Africa than the liberal distribution of toxic antiretroviral drugs in absence of nearly enough experienced physicians to ensure that treatment is changed or discontinued at the first sign of toxic side-effects.

31 Responses to “Grabbing a monster by the tail”

Philipsaid

Screening tests are meant to rule out. They could give false positives, but should not give many false negatives. An ELISA is supposed to be a screening test. Therefore, it should ALWAYS be confirmed. Such as a Hepatitis B surface antigen reactive result must be confirmed.

A confirmatory test, by definition, must rule in, not rule out. A confirmatory test by itself should have full diagnostic value, I think. The only reason for using screening tests instead of confirmatory tests all the time is cost effectiveness. For example, we can’t culture TB from everyone due to cost, but the PPD can be used to screen in non endemic for TB populations.

But the Western Blot shouldn’t be taken by itself, right? It should have ELISA. If I understand it right, a positive western blot is trumped by a negative ELISA. This doesn’t make sense to me because it’s like saying we cultured the TB but since the PPD was negative then there’s no TB bacilli…

And in my example, there’s no doubting the culture because it’s there, you see the big bad bug for yourself! There’s no mistaking it! In today’s virology, a few strands of DNA that could come from a lot of things is enough. Double duh.

Henry Bauersaid

Philip: Weiss & Cowan point out that there are no confirmatory HIV tests because there is no gold standard, and what are called confirmatory should be called supplemental — see Grabbing a monster by the tail.

Philipsaid

I realize that Henry. My comment was more of comparing it to TB or other bacterial diseases. In other words, the “culturing” serves as a gold standard. Now there are those who will claim that HIV is also cultured. We should point out that culturing in bacteriology is way different than what passes for culture in virology these days.

Norman B.said

I refer once again to the case of Eneydi Torres, accused of feloniously exposing four men to HIV by having sex with them. Her attorney, G. Baron Coleman, got the charges reduced to the equivalent of a traffic violation by challenging in pretrial motions the very basis of her positive diagnosis from tests that the manufacturers admit are inconclusive in legal disclaimers inserted into the test kits. All tests are as unreliable as the ones singled out by the South African group until they can detect the actual virus.

MacDonaldsaid

Re. ”Multiple studies have demonstrated that better outcomes are achieved in HIV-infected outpatients cared for by a clinician with HIV expertise.

Here is an excellent “real-time” example of the AIDS industry’s uncanny ability to deliver a study supporting the cry for more drugs whenever it is needed. The so-called DART Trial Team has just reported another set of fantastic results for Africans on HAART, even for those who received less than the best supervision. The Commentary says:

In much of sub-Saharan Africa, the scale-up of use of antiretroviral therapy has been so far achieved without routine laboratory monitoring of drug toxicity and efficacy. Until now, there has not been substantive evidence about the consequences of delivering antiretrovirals without such routine monitoring (…) In DART at enrolment, all participants started triple-drug antiretroviral therapy and were randomised to clinically driven monitoring versus laboratory plus clinical monitoring for toxicity (haematology and biochemistry) and efficacy (CD4-cell counts). Over 5 years, the proportions who had one or more serious adverse events were almost identical(…)The other particularly striking result from DART is the 5-year survival in both groups: 87% for clinical monitoring and 90% for laboratory plus clinical monitoring. Such rates of survival are for people in whom the initial median CD4-cell count was 86 cells per μL. For comparison, the survival in the Entebbe cohort of untreated HIV-positive people in 5 years was below 10% (data presented in the DART report), which emphasises the huge clinical benefits of antiretroviral therapy.

Not only is there practically no difference between laboratory monitoring and “clinically driven monitoring”. The overall death rates were astoundingly low. Above it says initial median cell count 86. Here are some further details:

DART was an open randomised trial enrolling symptomatic (WHO stage 2—4) HIV-infected adults (≥18 years) with CD4 counts less than 200 cells per μL who reported no previous ART apart from to prevent mother-to-child transmission.

In addition: Fully 1/3 of the 3300 participants had a CD4 count of less than 50 at baseline!

In other words, all participants had AIDS by the CDC definition, and probably most of them had AIDS by any definition. (the Commentary adds that they were “symptomatic”, whatever that means).

Another significant piece of information is that they were all ART naive apart from ART to prevent mother-to-child transmission. That means the study didn’t select for one of the most important factors: good drug tolerance. Poor drug tolerance is a, if not THE, major factor in high first-year mortality.

As the authors proudly point out, this is not only one of the most remarkable trial outcomes in Africa, but in the entire world. Since exact details of age and social and economic status are not given, it is difficult to say, but the study participants would probably hold up quite well even against non-HIV-infected peers.

In comparison, 5-year mortality in the allegedly comparable non-treatment Entebbe cohort was the inverse rate: 90%. The DART-Entebbe abstract presented at the 2006 International AIDS Conference reported an overall 2-year mortality reduced 17-fold after the introduction of ART:

CONCLUSIONS: First-line ART guided by clinical and immunological monitoring is highly effective: two year survival is 94% with overall mortality reduced 17-fold compared to a matched pre-ART cohort. Significant benefit accrues even in adults with very advanced disease.http://www.aegis.com/conferences/iac/2006/ThLB0208.html

Too good to be true? Whatever the answer, this is the kind of stuff we should be focusing on instead of the usual smaller or softer targets if we really want to grab the monster by the tail .

Henry Bauersaid

MacDonald: What can one do if the reports don’t give critical data like age?
More important: I think it’s precisely the soft targets, the Achilles heels, that should be attacked, not the peripheral matters like claimed treatment outcomes. The epidemiology of HIV and of AIDS shows quite clearly that they aren’t correlated (chapter 9, The Origin, Persistence and Failings of HIV/AIDS Theory [McFarland 2007]), and if two things aren’t correlated, then one doesn’t cause the other.
As you know, “HIV+” can result from any number of things, some of them illnesses, others not. ARVs are powerful antibiotics, and short-term applications can improve health, especially protease inhibitors against fungal infections. If the DART study enrolled a bunch of people ill with fungal or parasitic or bacterial infections and used low doses of ARVs, no reason why there shouldn’t be a high survival rate. But we aren’t told what their actual specific manifest illnesses were.

MacDonaldsaid

I think we all know what the real Achilles heel of the HIV/AIDS construct is, but for various reasons and in various contexts we engage the Opposition in other areas than their absolute soft spot. It’s when we do that we should seek out the hard targets

The AIDS Trap for instance claims without a single reference that AZT killed 300,000 people. Duesberg et al claim in their latest that HIV experts agree ARVs haven’t translated into lower mortality period.

Dissidents spend considerable amounts of energy and ink trying to persuade people that ARVs are toxic, and that the benefits don’t outweigh the risks. I we want to do that, and if we agree that this is a matter of public perception as much as the science, this is the sort of study we’d better have an answer to.

It looks so good that if it get’s shot down, it goes without saying that all the softer targets will fall by themselves.

One of the eligibility criteria in DART was that the subject had to be free of current infection. The antibiotic Lazarus effect explanation cannot be invoked.

Henry Bauersaid

MacDonald: Did you neglect to give a link to a more recent write-up than the 2006 abstract?
“The leading specific cause of death in EC was Cryptococcus (64 deaths; 16.8%) followed by Cryptosporidium(18 deaths; 4.7%) and tuberculosis (16 deaths; 4.2%)” doesn’t seem like “free of current infection”; so if the DARTs were free of current infection [except tuberculosis, of course: “The leading specific cause of death in DART was tuberculosis (10 deaths; 16.1%), followed by malignancy (6 deaths; 9.7%) and bacteraemia (5 deaths; 8.1%). Acute fever was the leading syndrome (12 deaths; 19.3%)”] then the comparison of EC and DART is of apples and oranges. “Acute fever” and “bacteraemia” might also be indciaitons of infection, I would think.

Francissaid

Philip, I’d like to recommend Janine Roberts book “Fear of the Invisible” if you haven’t already read it. There are some interesting facts and theories there that put some of the hocus pocus of virology into context, another good one is “Virus Mania”.

Henry, as previously stated I am a serving police officer. I’ve just been given an investigation to conduct into the activities of one of our larger pathology providers (no names yet). On the face of it, they have been billing the government for services not even rendered under our bulk-billing scheme. All of the 5 directors are “respectable” Doctors with varying pathology specialties. 2 have prior convictions for taxation fraud. They have been working in conjunction with numerous GPs in a kick-back scheme. The CEO of the company has been interviewed and stated openly that what they have been doing is common to all pathology companies and an accepted practice for the last 25 years that he knows of. He of course denies criminality and put the actions down to “business expediency”. Medicare, which funds this, has other ideas on the nature of this expediency, as do I.

A common theme that appears to run through this is that a lot of the GPs involved, have become so through the recommendations of senior GPs in the practice and are told that this is just the way it is. One has given a statement that when he initially declined the kind offer to give his provider number to the pathology company, his services could not be guaranteed at the clinic. Others have claimed that they were acting in good faith thinking that the pathology company wouldn’t break the law.

Of course this is just an example of the characters of some of the players in this industry, and we of course should trust them implicitly.

Back to Philip, sorry if the last post stung about greedy doctors not providing care. Of course I am sure there are many who enter medicine and persist with the best of intentions. Just as not every cop is crooked. I do admit though that there are some.

My own experiences with corruption are that it is an insidious process usually perpetrated through a culture within certain work areas. Newcomers are inducted slowly and pervasively and without knowing it; one day they discover that they are compromised and unable to escape unscathed, so remain. The majority of the others that don’t succumb simply turn a blind eye and keep quiet, knowing that to spill the beans is invariably a career buster. Retaining peer acceptance is also a powerful motivator. It takes a very very strong individual to open up spontaneously and is a rare event.

I strongly suspect that similar cultures and behaviours exist in the fields that perpetrate the HIV/AIDS dogma. As I say, “Follow the Money”, and there is an awful lot of it to follow. Self-regulation never works with law-enforcement agencies, I fail to see how anyone can believe that it does in medicine. Or perhaps they are morally and ethically above mere humans, I doubt it.

What I truly find perplexing, though, is that if a cop was actually caught out lying, stealing and cheating, he/she would be prosecuted/persecuted to the full extent. And even if they clung to their jobs, would never have any credibility again. How Gallo who escaped prosecution only through a limitation of time provision, could raise his head high again and be revered within the industry is a telling thing.

Henry Bauersaid

Francis: You have it exactly right. Here’s another example of corruption through “doing what everyone else does”: intercollegiate basketball and football in the United States. Commission after commission has suggested remedies for the exploitation of “student athletes” who get no education, are admitted without the pertinent background, are simply fodder for the entertainment of the crowds, think they have the benefit of getting a chance at professional playing when only a tiny fraction of them ever will. They’re recruited with the aid of party girls. The whole atmosphere in big-time colleges has little if anything to do with education. Everyone knows it. Everyone openly deplores “the excesses”. During the last three decades or so, it has only gotten worse. The chief culprit, again, is simply the money: from TV revenues and alumni. In many “top” colleges, the football coach is more influential than the president of the college.

Philipsaid

@Francis: No offense taken, Francis. Just a little clarification. There are hardly any doctors out there, in my opinion, who put on their coats every day and deliberately think, “well… I’m going to overprescribe. I’m going to intentionally order more lab tests.” Most sincerely believe they’re doing what they think is best for the patient. The problem is just that. They THINK it’s best. Why? Because that’s what’s shoved down our throats in medical school. It’s like why most doctors aren’t aware of the benefits of acupuncture — they aren’t taught it.

Second, the system does not reward those who think outside the box. If you do something unorthodox and it works, you still get stung for not following protocol.

Third, any inconsistencies in logic in current medical theory are subconsciously brushed aside due to the blind faith in our professors and the almighty published peer-reviewed studies. Imagine the shock medical students get when it is pointed out to them that AIDS does not behave like a typical STD. When I ask some students, “assuming that infection with STDs resulting in open sores like syphillis and chancroid, among others, hypothetically increases the risk of getting HIV, then it should be safe to assume that a) most HIV infections have co-infection with these STDs and b) the incidence for these STDs should AT LEAST match the incidence of HIV. Since this is not the case, how do we reconcile this?”; they end up with a “hey, you’ve got a point” look.

Honestly, independent thinking is no longer rewarded in medical science. We MDs have been transformed into big-pharma pill-dispensing machines.

Joesaid

Phillip, I think it might be a problem of generations who are brought up with the mass media and groupthink. I’m sure most doctors think they are not only rational and independent-minded, but also they probably think that they are scientific. (They probably think they are above-average intelligence, and are more good-looking than average too!)

I’m not medically trained and have got only the most tenuous grasp on mathematics. But even I can see from looking at publicly-available year-on-year data from STD clinics in the UK that AIDS & “infection with HIV” does not follow the same pattern as other STDs. It must be obvious to anyone who is medically trained or even with a scientific background that something is amiss.

And it’s not just with HIV/AIDS that medical specialists are choosing to wear blinkers. For almost a decade now I’ve been seeing doctors (GPs and specialists) about the various physical problems in my body. I am able to give them considerable detail about the triggers of pain, and the pains that have no observable trigger, and about the different kinds of pain I suffer — and instead of dealing with the causes and/or symptoms they classify me as being “over-sensitive” to pain! It’s not possible to them that I could be experiencing these pains, because they cannot see anything that would be causing them. Therefore, it is my rating of my sensations that is wrong.

The treatments they give me that they say will be beneficial don’t work, but they just shrug. When I persuaded them to perform a procedure that they say will have no benefit, and it was hugely beneficial, did they ask for any information or examine me further or ask other colleagues to talk to me? No.

So nothing is learned. No opinions are revised. Just ignore the evidence, and let the patient continue to suffer. If they can’t manage something like this, no wonder AIDS seems like a modern-day plague to them, and no wonder HIV seems like the microbial equivalent of superman. They seem to think any patient has 1 medical condition and that 1 medical condition will be caused by 1 physical/chemical/biological agent.

MacDonaldsaid

There’s a brand new study out (touted on AIDStruth of course), which refers “historically” to previous results in non-treated patients, presented at the 2006 AIDS Convention. That’s the one I linked. There’s also an accompanying Commentary to the new study, which I have quoted from, The study’s name is Routine versus clinically driven laboratory monitoring of HIV antiretroviral therapy in Africa (DART): a randomised non-inferiority trial

Under Methods, it states:

Exclusion criteria were: (…) presence of acute infection (patients could be admitted after recovery of an acute infection) or on intensive phase of antituberculosis therapy

I guess “current” infection was not a precise term, since there could have been chronic latent infections – like “HIV”.

Henry Bauersaid

MacDonald: At the moment it’s the third from the top. The LANCET article by the DART team is “Routine versus clinically driven laboratory monitoring of HIV antiretroviral therapy in Africa (DART): a randomised non-inferiority trial” Lancet 2010; 375: 123–31; the Commentary is “DART points the way for HIV treatment programmes”, pp. 96-8 by Andrew Phillips and Joep van Oosterhout.

What point are you wanting to make?
As many subjects were lost to follow-up in each arm as were known to have died, so the death rate might have been as high as twice the reported one. The comparison with pre-ART Entebbe is hardly detailed enough to judge how convincing or otherwise that might be: “*Data from HIV-infected population of similar disease stage between 1996 and 2000” — “similar disease stage” is not very informative.

Overall, we have here a study on 3000+ Africans concluding that monitoring doesn’t increase survival, as against the opposite view as the considered opinion of the NIH Panel that periodically revises the Treatment Guidelines. One might speculate that there’s something wrong with the African study…

In any case, this is scarcely a “hard target”, scarcely a convincing demonstration of the life-saving value of ART.

Francissaid

Philip, I agree that most MDs don’t get up thinking about rorting the system, my point is that the system itself is dishonest and self-perpetuating.

As for Medical School ramming a dogma down the throat, they certainly aren’t orphans, as there is to me a concerted effort to dumb things down across the board and questioning anything is a financially unhealthy pursuit.

It takes me back to when I was studying politics as part of a degree course. I find politics very interesting and have my own strong views in various areas (I’m a liberal). Anyway from the marking of my first assignment (C) it was obvious from the comments of the lecturer that his politics were slightly left of marxist. Now I’m not a boat-rocker by nature and I could have argued the point, at the risk of an (F), instead I adjusted my arguments to his politics and got straight “A”s, I didn’t believe a word of what I typed, but going with the flow was certainly easier and more productive for me.

In my own occupation there are many laws I enforce that I don’t agree with. On the odd occasion I’ve let my guard down and stated my opinion, the office “consensus” gives me the most queer looks and sometimes quite hostile reactions. Now most of these people aren’t fascist-type bully-boys, most are quite nice people but they do have ingrained opinions learned within the organisation and logic won’t shift their viewpoint. I’ve learnt not to bother.

I often lament that I was born with a questioning nature and analytical personality. It would be far simpler to be able to accept everything as a truth. After 25 years doing this, I now find that truth is a very vague concept and more a question of perception than reality.

Philipsaid

Francis, from your words I detect a kindred spirit. I’ve always had a questioning nature, always tried to see what things are like from another point of view.

I believe that while truth is absolute (either HIV is causative of AIDS or it isn’t) I do not believe that it is linear only (note that I did not say that either HIV causes AIDS or not – that’s too linear and one track). Also, I do not believe that any one human being or group of human beings can arguably say that they have a monopoly on truth. Catholic theology says (and I agree) that being material beings, our knowledge depends on what we experience through our senses or what is taught us. And since we are taught only tidbits of what others experience through or infer from our imperfect senses, then our knowledge of the “truth” is always imperfect. It is subject to bias, either personal or societal. Of course, I am equating “truth” with “reality” here. Slightly different from your definition, which I understand to be “truth” = “how we perceive reality”

Which brings us to another problem with HIV rethinkers and HIV non-rethinkers. I realize that when we rethinkers speak of AIDS, we probably refer to the condition that Gottlieb saw in his patients in the early 80s. When other say “AIDS” they mean the 1993 definition, including asymptomatic patients with a CD4 count < 200. So… we can say that truth is only as concrete as the definitions we hold.

MacDonaldsaid

1)7% (lost to follow up) is the same value as 10% is the same value as 13% (deaths in the two arms respectively), and that all those lost to follow-up were deaths in this trial, whereas those lost to follow up in other studies chosen as comparison all are alive,

then the gap in survival rates to account for shrinks to a mere 82% post-ART vs “less than 10%” pre-ART.

Now all we have to do is assume that,

2)when the researchers state things like “matched cohorts” and “similar “disease (WHO) stage”, they are both ignorant and liars, ignoring glaring differences in actual clinical health, that would produce an apparent instant 17-fold drop in mortality and sustain it quite well over 5 years,

and conclude that anything but short courses of ARVs for those with acute infections is a killer.

We can always hope that will hold next time we encounter Moore and “Fraser”, but my point, which you asked after, was not how this could be nit-picked to the applause of the dissident choir, but how it looks to the rest of the world and their MDs complared to our assertions that ARVs are toxic.

This is a seminal study (a Target), and, as it stands, it is hardly going to make a fence-sitter on the HAART-is-beneficial issue jump of the post and into our camp without a little more effort at showing what exactly “is wrong with the African study”. It IS a hard target because that and because of the reasons implied in point 2 above.

Leaving fraud aside, I think the researchers own remarks could be one of the keys here. Both arms of the post-HAART cohort were likely cared for considerably better than the pre-ART cohort, which would show that in such a context standard of care means a lot more than clinical vs laboratory monitoring of molecular markers:

“Some effects may be due to other improvements in healthcare over time, e.g. Cotrimoxasole”.

“Observed impact is in clinical setting with excellent follow-up and adherence”.

HAART vs no-HAART might not be the primary issue. One question is how well matched were these cohorts in terms of the care and nutrition they received apart from HAART?

Henry Bauersaid

MacDonald:
Your last sentence perhaps is all the answer required.
I simply don’t agree that it’s necessary to debunk specifically every study that gets published by the mainstream, no matter how much they might characterize it as ground-breaking or whatever. After all, they’ve said that sort of thing about vaccine trials, too.
Altogether and above all, I don’t agree that we should address our “Opposition” in the guise of the mainstream or its groupies. AIDS will not be Rethought as a result of convincing HIV/AIDS scientists or HIV/AIDS groupies, it will be Rethought after the mass media recognize that something is seriously wrong. I conceive my role as to keep plugging away, at points that strike me as particularly absurd or illustrative, in the hope that serendipity will turn up a lever with which to overturn the dogma; but it’ll have to be a PR lever, not a scientific issue. One possibility is that African Americans will start to rebel against the implication that black babies are born HIV+ 23 times more often than white babies because their parents are that much more carelessly promiscuous.
As Clark Baker and others including me have often pointed out, this is not a scientific controversy, in the sense that issues of science are at stake to be settled. The science is quite clear and has long been. HIV and AIDS are not correlated. HIV+ is not contagious. The racial disparities in HIV+ cannot be explained in terms of sexual behavior. The NIH Treatment Guidelines leave no doubt — to an unbiased observer — that all ARVs are highly toxic, and it doesn’t seem like a productive line of enquiry to find out why people don’t always die quickly on HAART.
For the same sort of reason, I find it unproductive to argue about what “HIV” is — all that matters is that HIV tests don’t detect a deadly infection.
More generally, when you write, “I think we all know . . . we engage the Opposition . . . when we do that”, who is “we”?
In several of my books (especially Enigma of Loch Ness; Science or Pseudoscience) I’ve described the difficulties faced by people who question a mainstream view, in particular that there’s no cohesion; no unanimity; a lack of constructive “peer review”; perpetual schisms and internecine disagreements.
Even more generally, it’s always whistling in the wind to assert what should be done. If you want something done, you need to do it yourself, I learned over the years of making suggestions for what should be done — the response would be, “Sure, go ahead!”; or even worse, “OK, you’re officially designated to do it”.
“The AIDS Trap” isn’t perfect, and the Medical Hypotheses paper by Duesberg et al. isn’t perfect, but I see no point in critizing them publicly. Constructive critiques are best communicated privately.
The stance I attempt to take — imperfectly, of course — is to do my thing, and to be appreciative of all the things done by other Rethinkers even when I might do them differently; because we cannot know what might eventually turn the tide. It could just as easily be something that’s highly flawed as something that isn’t, just so long as it causes a public fuss. The Elsevier withdrawal of the imperfect article has already had the great beneficial side-effect of alerting and arousing, via the Times Higher Education website and now the BMJ (340: c726), previously uncommitted people who understand that bullying and censorship are wrong; and I found it reassuring that when Moore et al. venture outside their closed little domain they find they cannot hold up their end of the matter.

Philipsaid

My step-daughter suggested I become a fan of THE MOVEMENT on FaceBook. I did and left a provocative posting in the discussions, mentioning your MedSeminar.pdf and stirred up one who objected. Nothing particularly new or interesting there, I think, but it’s another chance for someone who cares to find out that there is another point of view than the orthodox one on HIV/AIDS.

Henry Bauersaid

Richard Karpinski: Thank you! MyGoogle Alert had caught your comment in that discussion, but the the link you give here just gets me to my own Facebook page. I suspect a glitch in the Facebook software.

Nick Naylorsaid

“One of the eligibility criteria in DART was that the subject had to be free of current infection.”

MacDonald,

Some would argue that this in itself means the DART patients did not have AIDS! (See Mullis etc.)

The dosage is critical since one can even invoke “hormesis” theory to explain these results.

I agree on your other points directed at constructive criticism of RA approach. They are well taken, and should be by considered in public presentations, given the inherent problem with public perception of RA — the denialists.

“But there’s no such thing as a confirming HIV test, according to ‘Laboratory detection of human retroviral infection’ by Stanley H. Weiss and Elliott P. Cowan, Chapter 8 in AIDS and Other Manifestations of HIV Infection, ed. Gary P. Wormser, 4th ed. (2004). None of the tests are capable of establishing the presence of HIV infection; all results should be expressed as probabilities; so-called ‘confirmatory’ tests are actually only supplemental tests, to be used only as additional adjuncts to clinical observation and medical histories. ‘Each individual assay has its own associated special characteristics and is not interchangeable with other assays, even within a given class of test’ (p. 148). ‘In the absence of gold standards, the true sensitivity and specificity for the detection of HIV antibodies remain somewhat imprecise’ (p. 150).”

As I’ve said before, everything about HIV/AIDS paradigm is “hidden in plain site” [ED.: may I assume “sight”?]. No need to invoke conspiracy theories.

But institutional arrangements, as Francis has outlined above, that “incorporate” people’s unconscious survival “instincts” can explain the context of studies “too good to be true”.

Henry Bauersaid

Nick Naylor, Gene: As I pointed out, it’s futile to expect Duesberg, or anyone else, to take the same view as you do on what needs to be done, on what top priority is. Duesberg’s has been for a long time the matter of cancer and the aneuploidy theory. He debunked HIV/AIDS theory two decades ago. He gets aroused again on HIV/AIDS matters when, for example, he is charged baselessly with complicity in the deaths of hundreds of thousands of people. Why should he waste his time responding to and debunking every study the prolific HIV/AIDS crank-turning machine generates?
As to “public perception of RA” — are you accepting the assertions of a mere handful of people?

Philipsaid

My statement—taken out of its context in a film that glorifies the “Dissidents” and posted on Internet by a website that is searching for polemical debate—is based on observations I made while I was director of the Centre of reference on AIDS virology at the Pasteur Institute: we actually met several cases of persons being transitively HIV–positive for a few months and then turning HIV–negative again. (emphasis mine)
This is difficult to detect, keeping count of the furtive nature of the infection, but, when applied to AIDS, it simply reflects a general phenomenon that can be found in many viral infections: under the effect of a good immune response, these will disappear after a few weeks.

In the case of HIV, this explains the enormous disparity of prevalence between the North (0,1% in our countries) and the South (5 to 10% in Africa). In southern areas, for a lot of reasons (such as co–infections or malnutrition), the immune system of many Africans is weakened and allows chronic infection to HIV.

These cases of people being transitively HIV–positive do not minimize the dangerous nature of HIV, which remains the key factor in the onset of AIDS, but they suggest that a regression of the epidemic can be obtained in Africa by taking general health measures”.

My take:
So if a person has a good immune system, they shouldn’t fear HIV, but if HIV kicks in it means that you are ALREADY immune deficient to begin with! So why blame the immune system crash on HIV, which now appears to be a consequence rather than a cause of the immune deficiency?

And the scary part is, Montagnier admits to seeing patients who spontaneously serorevert. I’ll bet this quote never gets to the mass media.

cathysaid

David it was on rethinkingaids.com in a piece by Djamel Tahi:
“Here is the answer that NEXUS Magazine editorial office received from Luc Montagnier, and which has been published in the January–February 2010 issue (Issue 66, pp 10–11),”.